According to the new market research “Healthcare Fraud Detection Market by Type (Descriptive, Prescriptive), Application (Insurance Claim, Prepay, Post payment), Component (Service, Software), Delivery (On-premise, Cloud), End user (Insurance Payer, Private, Public) - Global Forecast to 2022", analyzes and studies the major market drivers, restraints/challenges, and opportunities. The healthcare fraud detection market is expected to reach USD 2,242.7 Million by 2022 from USD 631.0 Million in 2017, at a CAGR of 28.9%. 

The global Healthcare Fraud Detection market is segmented based on type, application and regions.

Based on type, the healthcare fraud detection market is segmented descriptive, predictive, and prescriptive analytics. In 2017, the descriptive analytics segment is expected to account for the largest share of the healthcare fraud detection market. Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics. Thus, descriptive analytics is expected to continue to dominate the healthcare fraud detection market during the forecast period.

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Based on application, the healthcare fraud detection market is segmented into insurance claims review, payment integrity, and other applications. The insurance claims review segment is expected to dominate the healthcare fraud detection market with a share in 2017. This segment is also expected to register the highest growth rate during the forecast period, primarily due to the increasing number of patients seeking health insurance, rising number of fraudulent claims, and growing adoption of the prepayment review model.

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In 2017, North America is expected to dominate the market followed by Europe. The large share of the North American segment is attributed to factors such as increase in the number of people seeking health insurance, increasing cases of healthcare fraud, favorable government initiatives to combat healthcare fraud, rising pressure to reduce healthcare costs, technological advancements, and greater product and service availability in this region.

Market Players

The key players in the Healthcare Fraud Detection market are IBM (US), Optum (US), SAS (US), McKesson (US), SCIO (US), Verscend (US), Wipro (India), Conduent (US), HCL (India), CGI (Canada), DXC (US), Northrop Grumman (US), LexisNexis (US), and Pondera (US).

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The global Healthcare Fraud Detection Market is expected to reach USD 2,242.7 Million by 2022 from USD 631.0 Million in 2017, at a CAGR of 28.9%.

The Research report provides a detailed overview of the major drivers, restraints, challenges, opportunities, current market trends, and strategies impacting the Healthcare Fraud Detection Market, along with revenue estimates & forecasts and market share analysis.

The growth of the market is attributed to a large number of fraudulent activities in healthcare; increasing number of patients seeking health insurance; the prepayment review model; growing pressure of fraud, waste, and abuse on healthcare spending; and high returns on investment.

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Healthcare Fraud Detection Market segmentation:

• Based on Type
• Based on Component
• Based on Delivery Model
• Based on Application
• Based on End Users
• Based on Regions

The Major Players Opearting in the Healthcare Fraud Detection Market:

Key players in the Healthcare Fraud Detection Market include IBM (US), Optum (US), SAS (US), McKesson (US), SCIO (US), Verscend (US), Wipro (India), Conduent (US), HCL (India), CGI (Canada), DXC (US), Northrop Grumman (US), LexisNexis (US), and Pondera (US).

IBM was the leading player in the global Healthcare Fraud Detection Market.

The company has a strong presence in North America, Europe, Asia, and Latin America.

The company has a strong presence in the commercial and government healthcare payer markets. Moreover, it has a strong sales and distribution network in more than 175 countries. IBM invests heavily in research activities to continuously improve its product portfolio.The company focuses on inorganic strategies like acquisitions and partnerships. For instance, in April 2016, IBM acquired Truven (US), a provider of cloud-based healthcare data, analytics, and insights. This acquisition strengthened IBM’s product portfolio for fraud, waste, and abuse detection and customer base.

Geographical Detailed Analysis for Healthcare Fraud Detection Market:

North America is expected to dominate the market followed by Europe.

The large share of the North American segment is attributed to factors such as increase in the number of people seeking health insurance, increasing cases of healthcare fraud, favorable government initiatives to combat healthcare fraud, rising pressure to reduce healthcare costs, technological advancements, and greater product and service availability in this region.

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